Active NPI
Mary Katherine Roberts, MA,CCC/A
- Audiologist
- Tyler, TX
National Provider Identifier
1326219205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 50890
- Practice address
- 3413 Golden Rd
Tyler, TX 75701-8355 - Phone
- (903) 592-5601
- Fax
- (903) 595-3304
- NPI assigned
- Mar 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 50890 | TX | Primary |
Addresses
Primary practice location
3413 Golden Rd
Tyler, TX 75701-8355
Mailing address
3413 Golden Rd
Tyler, TX 75701-8355
Phone (903) 592-5601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50890 | TX | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tyler Radiology Associates PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Tyler, TX
- NPI 1750341277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1326219205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3413 GOLDEN RD",
"city": "TYLER",
"state": "TX",
"postal_code": "757018355",
"telephone_number": "903-592-5601",
"fax_number": "903-595-3304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3413 GOLDEN RD",
"city": "TYLER",
"state": "TX",
"postal_code": "757018355",
"telephone_number": "903-592-5601",
"fax_number": "903-595-3304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MARY",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "MA,CCC/A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-18",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "50890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.